Imaging prices at Good Samaritan Regional Medical Center

Corvallis, OR · every code in this section with a posted price and a Medicare benchmark.

370 codes. Prices are the hospital's own posted facility charges.

Compare against other hospitals interactively →

ProcedurePosted cashPosted gross× Medicare
3-D radiotherapy plan dose-volume histograms (77295) $6,744 $8,430 4.4×
Abdomen 1 View (74018) $240 $300 2.5×
Abdomen 2 views (74019) $256 $320 2.2×
Acute Gastrointestinal Blood Loss Imaging (78278) $1,144 $1,430 2.6×
Angio internal mammary (75756) $6,384 $7,980 1.8×
Angio pulmonary bilat (75743) $3,784 $4,730 1.1×
Angiography extremity bilateral rs&i (75716) $5,768 $7,210 1.6×
Angiography extremity unilateral rs&i (75710) $4,480 $5,600 1.3×
Angiography pulmonary unilateral slctv rs&i (75741) $5,376 $6,720 1.5×
Ankle 2 views (73600) $280 $350 2.9×
Aortography thoracic serialography rs&i (75605) $6,440 $8,050 1.0×
Aortography thoracic w/o serialography rs&i (75600) $4,078.40 $5,098 1.2×
Artery X-Rays Abdomen (75726) $7,712 $9,640 1.2×
Artery X-Rays Pelvis (75736)
range across 2 matching MRF lines		 $7,712 $323–$9,640 1.2×
Artery X-Rays Spine (75705) $7,408 $9,260 1.2×
Arthrogram ankle (73615) $696 $870 1.8×
Arthrogram hip (73525) $728 $910 1.9×
Arthrogram Wrist (73115) $696 $870 1.8×
Basic radiation dosimetry calculation (77300) $568 $710 3.8×
Bone age studies (77072) $264 $330 2.3×
Bone Imaging 3 Phase (78315) $1,240 $1,550 2.8×
Bone Imaging Limited Area (78300) $880 $1,100 2.0×
Bone Imaging Multiple Areas (78305) $968 $1,210 2.2×
Bone Imaging Whole Body (78306) $1,144 $1,430 2.6×
Bone survey infant (77076) $408 $510 3.5×
Brachytx isodose complex (77318) $1,088 $1,360 2.6×
Brain Image W/Flow < 4 Views (78601) $848 $1,060 1.9×
Brain imaging < 4 static views (78600) $648 $810 1.5×
Brain Imaging Pet Metabolic Evaluation (78608)
range across 4 matching MRF lines		 $5,200–$5,528 $6,500–$6,910 varies
Cardiac MRI w/w/o contrast & further seq (75561) $2,224 $2,780 5.7×
Cardiac MRI w/w/o contrast w/stress (75563) $2,224 $2,780 2.6×
Cat Scan Follow-Up Study (76380) $552 $690 5.7×
Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) $800 $1,000 1.3×
Cerebrospinal Fluid Scan (78630) $1,240 $1,550 2.1×
Chest 1 view (71045) $264 $330 2.7×
Chest 2 views (71046) $296 $370 3.1×
Chest 3 views (71047) $320 $400 3.3×
Chest 4 or more views (71048) $416 $520 3.6×
Cholecystography Oral Contrast (74290) $504 $630 2.6×
Clavicle complete (73000) $216 $270 2.2×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $264 $330 2.3×
Continuing medical physics consltj pr wk (77336) $680 $850 4.6×
Contrast Exam Abdominl Aorta (75625) $5,256 $6,570 1.5×
Contrast X-Ray Bladder (74430) $576 $720 1.5×
Contrast X-Ray Of Elbow (73085) $704 $880 1.8×
Contrast X-Ray Of Knee Joint (73580) $664 $830 1.7×
CT abdomen and pelvis without and with contrast (74178) $2,304 $2,880 5.9×
CT abdomen and pelvis without contrast (74176) $1,536 $1,920 5.8×
CT abdomen w contrast (74160) $1,152 $1,440 5.9×
CT abdomen w wo contrast (74170) $1,376 $1,720 7.1×
CT abdomen w/o contrast (74150) $920 $1,150 7.9×
CT Angio Abdomen and Pelvis (74174) $1,608 $2,010 4.1×
CT Angio Chest (71275) $1,376 $1,720 7.1×
CT Angio Head (70496) $1,376 $1,720 7.1×
CT angio hrt w/3d image (75574) $1,392 $1,740 3.6×
Ct Angio Lwr Extr W/O&W/Dye (73706) $1,392 $1,740 7.1×
CT Angio Neck (70498) $1,376 $1,720 7.1×
Ct Angio Upr Extrm W/O&W/Dye (73206) $1,640 $2,050 8.4×
CT cervical spine w/ contrast (72126) $1,640 $2,050 4.2×
CT cervical spine w/o contrast (72125) $920 $1,150 7.9×
CT cervical spine w/wo cont (72127) $2,040 $2,550 10.5×
CT chest w contrast (71260) $1,152 $1,440 5.9×
CT chest w/wo contrast (71270) $1,376 $1,720 7.1×
CT colonogrphy dx image postprocess w/o contrast (74261) $1,792 $2,240 15.4×
CT head/brain with contrast (70460) $1,152 $1,440 5.9×
CT head/brain without and with contrast (70470) $1,376 $1,720 7.1×
CT heart contrast eval cardiac structure&morph (75572) $1,152 $1,440 3.0×
CT heart no contrast quant eval coronry calcium (75571) $352 $440 3.6×
CT hrt w/3d image congen (75573) $992 $1,240 2.6×
CT iac w contrast (70481) $1,152 $1,440 5.9×
CT l-spine w&w/o contrast (72133) $2,040 $2,550 10.5×
CT lower ext w/o (73700) $920 $1,150 7.9×
CT lower extremity w/contrast material (73701) $1,152 $1,440 5.9×
CT lumbar spine w contrast (72132) $1,536 $1,920 4.0×
CT lumbar spine w/o contrast (72131) $920 $1,150 7.9×
CT maxillofacial w contrast (70487) $1,152 $1,440 5.9×
CT maxillofacial wo contrast (70486) $920 $1,150 7.9×
CT neck tissue combo (70492) $1,376 $1,720 7.1×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $1,376 $1,720 7.1×
CT orbits w/o contrast (70480) $920 $1,150 7.9×
CT pelvis w&w/o contrast (72194) $1,376 $1,720 7.1×
CT pelvis w/o contrast (72192) $920 $1,150 7.9×
CT scan of leg combo (73702) $1,376 $1,720 7.1×
CT scans face/jaw combo (70488) $1,376 $1,720 7.1×
CT soft tissue neck w contrast (70491) $1,152 $1,440 5.9×
CT soft tissue neck w/o contrast (70490) $920 $1,150 7.9×
CT thoracic spine w contrast (72129) $1,152 $1,440 5.9×
CT thoracic spine w/o contrast (72128) $920 $1,150 7.9×
CT thoracic spine w/wo cont (72130) $1,080 $1,350 5.5×
CT thorax w/o contrast (71250) $920 $1,150 7.9×
CT unlisted procedure (76497) $216 $270 2.2×
CT upper ext wo (73200) $920 $1,150 7.9×
CT upper extremity w/o & w/contrast material (73202) $1,160 $1,450 5.9×
CT upper extremity with contrast (73201) $1,392 $1,740 3.6×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $1,568 $1,960 8.0×
Cta Abdomen (74175) $1,376 $1,720 7.1×
CTA pelvis (72191) $1,376 $1,720 7.1×
Dilation ureters/urethra rs&i (74485) $2,528 $3,160 1.1×
Doppler Fetal Mid Cerebral Artery (76821) $232 $290 2.0×
Dxa Bone Density Axial (77080) $384 $480 3.3×
Dxa bone density study (77085) $224 $280 1.9×
Dxa bone density study 1/>sites appendiclr skel (77081) $256 $320 2.6×
Echo exam uterus (76831) $696 $870 2.6×
Echo Guide For Artery Repair (76936) $1,056 $1,320 4.4×
Esophagram (74220) $640 $800 3.3×
Fetal Biophys Profile W/Nst (76818) $528 $660 4.5×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $528 $660 4.5×
Fluoroscopy up to 1 hr (76000) $704 $880 2.7×
Follow-Up Angiography (75898) $3,784 $4,730 1.1×
Foot 2 views (73620) $224 $280 2.3×
Forearm 2 views (73090) $264 $330 2.7×
Gastric emptying imaging study (78264) $1,144 $1,430 2.6×
Gated Heart Planar Single (78472) $1,144 $1,430 2.6×
Hand 2 views (73120)
range across 3 matching MRF lines		 $184–$368 $230–$460 varies
Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) $5,376 $6,720 1.5×
Hepatobil Syst Image W/Drug (78227) $1,408 $1,760 2.3×
Hepatobiliary System Imaging (78226) $1,320 $1,650 3.0×
Ht Muscle Image Spect Sing (78451) $2,120 $2,650 1.5×
Hysterosalpingogram (74740) $728 $910 2.7×
Infant hip ultrasound with hip movement (dynamic) (76885) $416 $520 4.3×
Infant hip ultrasound, limited static exam (76886) $328 $410 3.4×
Infusion Ivp (74410) $680 $850 3.5×
Joint Survey Single View (77077) $139.20 $174 1.2×
K Flow/Funct Image Multiple (78709) $1,016 $1,270 1.7×
K Flow/Funct Image W/Drug (78708) $1,408 $1,760 2.3×
K Flow/Funct Image W/O Drug (78707) $1,240 $1,550 2.1×
Kidney Imaging Morphol (78700) $752 $940 1.7×
Knee 3 Views (73562) $304 $380 3.1×
Leveen/Shunt Patency Exam (78291) $424 $530 1.0×
Liver & Spleen Imaging Static Only (78215) $864 $1,080 1.9×
Liver imaging static only (78201) $712 $890 1.2×
Lung Perf&Ventilat Diferentl (78598) $1,320 $1,650 2.2×
Lung perfusion differential (78597) $880 $1,100 2.0×
Lung Ventilat&Perfus Imaging (78582) $1,504 $1,880 2.5×
Lung Ventilation Imaging (78579) $648 $810 1.5×
Lymph System Imaging (78195) $1,240 $1,550 2.1×
Magnetic Image Jaw Joint (70336) $1,424 $1,780 5.4×
Mammary ductogram or galactogram single (77053) $656 $820 2.5×
Meckels Divert Exam (78290) $1,144 $1,430 2.6×
Mlc imrt design & construction per imrt plan (77338) $1,288 $1,610 3.1×
Mr safety determination physician/other qhp (76016) $117.60 $147 1.2×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $32.80 $41 1.0×
Mra Head W/O & W/Contrast Material (70546) $2,760 $3,450 7.1×
MRA head w/o contrast (70544) $1,872 $2,340 7.1×
MRA head with contrast (70545) $2,312 $2,890 6.0×
MRA neck w contrast (70548) $2,224 $2,780 5.7×
Mra Neck W/O &W/Contrast Material (70549) $2,672 $3,340 6.9×
MRA neck w/o contrast (70547) $1,776 $2,220 6.7×
MRI abdomen w contrast (74182) $2,224 $2,780 5.7×
MRI abdomen w/o contrast (74181) $1,776 $2,220 6.7×
MRI any jt lower extrem w/contrast material (73722) $2,224 $2,780 2.6×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $2,672 $3,340 6.9×
MRI any jt upper extremity w/contrast matrl (73222) $2,224 $2,780 2.6×
MRI bone marrow blood supply (77084) $1,872 $2,340 7.1×
MRI Breast W/O Contrast Bilateral (77047) $1,776 $2,220 6.7×
MRI Breast Without Contrast Material Unilateral (77046) $888 $1,110 3.3×
MRI cardiac w/o contrast (75557) $1,776 $2,220 6.7×
MRI cervical spine w contrast (72142) $2,224 $2,780 5.7×
MRI cervical spine w/o cont (72141) $1,776 $2,220 6.7×
MRI chest w/o contrast (71550) $1,776 $2,220 6.7×
MRI chest with contrast (71551) $3,160 $3,950 3.6×
MRI chest wo w contrast (71552) $2,760 $3,450 7.1×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $2,224 $2,780 5.7×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $2,672 $3,340 6.9×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,776 $2,220 6.7×
MRI lumbar spine w contrast (72149) $2,224 $2,780 5.7×
Mri Neck Spine W/O & W/Dye (72156) $2,672 $3,340 6.9×
MRI orbit face &/neck w/o contrast (70540) $1,776 $2,220 6.7×
MRI orbit face neck w contrast (70542) $2,224 $2,780 5.7×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $2,672 $3,340 6.9×
MRI pelvis w contrast (72196) $2,224 $2,780 5.7×
MRI pelvis w/o & w contrast (72197) $2,672 $3,340 6.9×
MRI pelvis w/o contrast (72195) $1,776 $2,220 6.7×
MRI spectroscopy (76390) $1,200 $1,500 12.4×
MRI thoracic spine w/o contrast (72146) $1,776 $2,220 6.7×
MRI upper extremity oth than jt w/contr matrl (73219) $2,224 $2,780 5.7×
MRI upper extremity oth than jt w/o contr matrl (73218) $1,776 $2,220 6.7×
Mri Uppr Extremity W/O&W/Dye (73220) $2,672 $3,340 6.9×
MRI, abdomen, combo (74183) $2,672 $3,340 6.9×
MRI, dorsal spine combo (72157) $2,672 $3,340 6.9×
MRI, dorsal spine contrast (72147) $2,104 $2,630 5.4×
MRI, joint upper extrem (73221) $1,776 $2,220 6.7×
MRI, joint upper extrem combo (73223) $2,672 $3,340 6.9×
MRI, lumbar spine combo (72158) $2,672 $3,340 6.9×
Myelogram cervical (72240) $1,280 $1,600 1.5×
Myelogram Lumbar (72265) $1,256 $1,570 1.4×
Myelography thoracic (72255) $1,280 $1,600 1.5×
Myelograpy 2/more regions rs&i (72270) $1,544 $1,930 1.8×
Myocardial Spect Multiple Studies (78452) $2,800 $3,500 1.9×
Neck soft tissue (70360) $264 $330 2.7×
Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) $432 $540 1.0×
Nm csf leak detection (78650) $1,456 $1,820 1.0×
Nonvascular Shunt X-Ray (75809) $416 $520 3.6×
Ntsty modul radthx pln dose-vol histos (77301) $7,200 $9,000 4.7×
Nuclear Rx Intra-Arterial (79445) $480 $600 1.9×
Nuclear Rx Oral Admin (79005) $728 $910 2.8×
Ob us nuchal meas 1 gest (76813) $392 $490 3.4×
Ophthalmic us dx quantitative a-scan only (76511) $168 $210 1.4×
Optic foramina (70190) $136 $170 1.4×
Parathyroid imaging w/tomographic spect & CT (78072) $1,320 $1,650 2.2×
Parathyroid Planar Imaging (78070) $1,144 $1,430 2.6×
Parathyroid planar imaging w/wo subtraction (78071) $960 $1,200 2.2×
Pelvis 1 or 2 views (72170) $424 $530 3.6×
Pet Image W/Ct Lmtd (78814) $5,312 $6,640 3.3×
PET image w/CT, full body (78816)
range across 4 matching MRF lines		 $5,504–$5,744 $6,880–$7,180 varies
PET imaging CT attenuation skull base mid-thigh (78815)
range across 4 matching MRF lines		 $5,976–$6,408 $7,470–$8,010 varies
Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) $5,376 $6,720 1.5×
Pulmonary Perfusion Imaging Particulate (78580) $1,144 $1,430 2.6×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $360 $450 3.1×
Radex abscess/fistula/sinus tract rs&i (76080) $816 $1,020 1.3×
Radex Ankle Complete Minimum 3 Views (73610) $312 $390 3.2×
Radex Calcaneus Minimum 2 Views (73650) $248 $310 2.6×
Radex elbow complete minimum 3 views (73080) $240 $300 2.5×
Radex Facial Bones Complete Minimum 3 Views (70150) $368 $460 3.2×
Radex fingr minimum 2 views (73140) $256 $320 2.6×
Radex foot complete minimum 3 views (73630) $336 $420 3.5×
Radex Hand Minimum 3 Views (73130) $336 $420 3.5×
Radex lower extremity infant minimum 2 views (73592) $296 $370 3.1×
Radex Nasal Bones Complete Minimum 3 Views (70160) $216 $270 2.2×
Radex Ribs Unilateral 2 Views (71100) $264 $330 2.7×
Radex shoulder complete minimum 2 views (73030) $280 $350 2.9×
Radex Sinuses Paransl < 3 Views (70210) $168 $210 1.7×
Radex Spine 1 View Specify Level (72020) $264 $330 2.7×
Radex Sternum Minimum 2 Views (71120) $224 $280 2.3×
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $296 $370 3.1×
Radex Toe Minimum 2 Views (73660) $184 $230 1.9×
Radex upper extremity infant minimum 2 views (73092) $184 $230 1.6×
Radex Wrist Complete Minimum 3 Views (73110) $376 $470 3.9×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $416 $520 3.6×
Radiation Delivery Stereotactic Cranial Linear (77372) $11,464 $14,330 1.4×
Radiation treatment delivery level 1 (77402) $480 $600 4.2×
Radiation treatment delivery level 2 (77407) $728 $910 1.7×
Radiation treatment delivery level 3 (77412) $800 $1,000 1.3×
Radiolog exam mandible compl minimum 4 views (70110) $376 $470 3.2×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $264 $330 2.3×
Radiologic exam colon double contrast study (74280) $584 $730 3.0×
Radiologic exam colon single contrast study (74270) $568 $710 2.9×
Radiologic Exam Esophagus Double Contrast Study (74221) $680 $850 3.5×
Radiologic exam knee complete 4/more views (73564) $400 $500 3.4×
Radiologic exam pelvis compl minimum 3 views (72190) $376 $470 3.2×
Radiologic Exam Small Int Single Contrast Study (74250) $416 $520 2.1×
Radiologic exam swallow function contrast study (74230) $752 $940 3.9×
Radiologic exam upr gi trc double contrast study (74246) $640 $800 3.3×
Radiologic examination femur 1 view (73551) $248 $310 2.6×
Radiologic examination femur minimum 2 views (73552) $304 $380 3.1×
Radiologic examination knee 1/2 views (73560) $264 $330 2.7×
Radiologic Examination Osseous Survey Limited (77074) $416 $520 3.6×
Radiologic Examination Salivary Gland Calculus (70380) $136 $170 1.4×
Radiologic examination tibia & fibula 2 views (73590) $296 $370 3.1×
Renal Cyst Study (74470) $784 $980 1.3×
Ribs bilateral 3 views (71110) $368 $460 3.2×
Rp loclzj tum plnr 1 area single day imaging (78800) $1,144 $1,430 2.6×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $1,128 $1,410 2.5×
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) $1,760 $2,200 2.9×
Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) $1,760 $2,200 2.9×
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) $1,680 $2,100 2.8×
Rp loclzj tum spect 2 area/sep acquisj img (78831) $1,808 $2,260 1.3×
Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) $1,944 $2,430 1.2×
Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) $1,680 $2,100 1.2×
Rp Therapy Intravenous Administration (79101) $480 $600 1.9×
Scapula (73010) $280 $350 2.4×
Screening Digital Breast Tomosynthesis Bi (77063) $120 $150 5.1×
Shoulder 1 view (73020) $248 $310 2.6×
Shoulder Arthrography (73040) $728 $910 1.9×
Sialogram (70390) $560 $700 2.1×
Skull less than 4 views (70250) $280 $350 2.4×
Special dosimetry (77331) $400 $500 2.7×
Special Physics Consult (77370) $1,016 $1,270 6.8×
Special teletherapy port plan (77321) $1,248 $1,560 3.0×
Special treatment procedure (77470) $1,712 $2,140 2.8×
Stereotactic Body Radiation Delivery (77373) $7,384 $9,230 3.7×
Sternoclavicular joints (71130) $224 $280 2.3×
Telethx isodose pln cplx w/basic dosimetry (77307) $1,928 $2,410 4.6×
Telethx isodose pln smpl w/dosimetry calculation (77306) $952 $1,190 2.3×
Ther Rad Simulaj-Aided Field Setting Complex (77290) $1,608 $2,010 3.9×
Ther Rad Simulaj-Aided Field Setting Intermed (77285) $1,024 $1,280 2.5×
Ther rad simulaj-aided field setting simple (77280) $760 $950 5.1×
Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) $232.80 $291 1.2×
Thoracic spine 2 views (72070) $320 $400 2.8×
Thoracic spine 3 views (72072) $376 $470 3.2×
Thoracolumbar 2 views (72080) $376 $470 3.9×
Thyroid Imaging With Vascular Flow (78013) $448 $560 1.0×
Thyroid Met Imaging Body (78018) $1,408 $1,760 2.3×
Thyroid Uptake Measurement (78012) $432 $540 1.0×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $864 $1,080 1.9×
Tx Devices Design & Construction Complex (77334) $1,384 $1,730 3.3×
Tx devices design & construction intermediate (77333) $880 $1,100 5.9×
Tx devices design & construction simple (77332) $824 $1,030 5.5×
Ultrasound Breast Limited (76642) $304 $380 3.1×
Ultrasound elastography first target lesion (76982) $480 $600 4.1×
Ultrasound Elastography Parenchyma (76981) $480 $600 4.1×
Ultrasound Exam Aaa Screen (76706) $456 $570 3.9×
Ultrasound, abdomen limited (76705) $528 $660 4.5×
Umbilical-artery Doppler (OB) (76820) $208 $260 1.8×
Unlisted Dx Radiographic Procedure (76499) $112 $140 1.2×
Unlisted us procedure (76999) $272 $340 2.8×
Upper gi w/o kub (74240) $520 $650 2.7×
Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) $408 $510 36.9×
Urea breath test c-14 isotopic analysis (78268) $168 $210 1.8×
Urethrocystogram voiding (74455) $480 $600 1.8×
Urethrocystography retrograde (74450) $672 $840 2.5×
Us breast unilateral complete (76641) $360 $450 3.1×
Us chest (76604) $360 $450 3.1×
Us complete joint (76881) $528 $660 4.5×
Us exam, pelvic, limited (76857) $440 $550 3.8×
Us head (76506) $464 $580 4.0×
Us kidney transplant (76776) $760 $950 6.5×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $256 $320 2.2×
Us ob detailed single fetus (76811) $944 $1,180 3.6×
Us ob limited 1 or more fetuses (76815)
range across 2 matching MRF lines		 $392–$400 $490–$500 varies
Us ob transvaginal (76817) $400 $500 3.4×
Us pelvic non ob complete (76856) $592 $740 5.1×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $592 $740 5.1×
Us preg uterus real time f/u trnsabdl per fetus (76816)
range across 2 matching MRF lines		 $392–$472 $490–$590 varies
Us retroperitoneal complete (76770) $704 $880 6.1×
Us retroperitoneal limited (76775) $464 $580 4.0×
Us scrotum and contents (76870) $640 $800 5.5×
Us spinal canal and contents (76800) $616 $770 5.3×
Us thyroid (76536) $528 $660 4.5×
Us transrectal (76872) $336 $420 2.9×
Vein X-Ray Chest (75827) $2,104 $2,630 1.2×
Venography caval inferior serialography rs&i (75825) $4,624 $5,780 1.3×
Venography extremity bilateral rs&i (75822) $2,384 $2,980 1.4×
Venography extremity unilateral rs&i (75820) $1,960 $2,450 1.1×
Venography Renal Bilateral (75833) $5,264 $6,580 1.5×
Venography Renal Unilateral (75831) $5,376 $6,720 1.5×
Vertebral fracture assessment via dxa (77086) $112 $140 1.2×
Wrist 2 views (73100) $264 $330 2.7×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $296 $370 3.1×
X-ray antegrade pyelogram tube (74425) $968 $1,210 2.5×
X-Ray Aorta Leg Arteries (75630) $4,056 $5,070 1.2×
X-Ray Bend Only L-S Spine (72120) $184 $230 1.6×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $384 $480 4.0×
X-Ray Exam Breast Specimen (76098) $1,784 $2,230 2.9×
X-Ray Exam Entire Spi 1 Vw (72081) $168 $210 1.7×
X-Ray Exam Entire Spi 2/3 Vw (72082) $384 $480 3.3×
X-Ray Exam Entire Spi 4/5 Vw (72083) $400 $500 3.4×
X-Ray Exam Hip Uni 1 View (73501) $232 $290 2.4×
X-Ray Exam Hip Uni 2-3 Views (73502) $272 $340 2.8×
X-Ray Exam Hip Uni 4/> Views (73503) $288 $360 2.5×
X-Ray Exam Hips Bi 2 Views (73521) $376 $470 3.2×
X-Ray Exam Hips Bi 3-4 Views (73522) $456 $570 3.9×
X-Ray Exam Hips Bi 5/> Views (73523) $504 $630 4.3×
X-Ray Exam L-S Spine Bending (72114) $336 $420 2.9×
X-Ray Exam Neck Spine 2-3 Vw (72040) $256 $320 2.6×
X-Ray Exam Neck Spine 6/>Vws (72052) $408 $510 3.5×
X-Ray Exam Unilat Ribs/Chest (71101) $328 $410 2.8×
X-ray eye for foreign body (70030) $296 $370 3.1×
X-ray humerus (73060) $360 $450 3.7×
X-ray IV pyelogram (ivp) (74400) $680 $850 3.5×
X-ray IV pyelogram+tomography (74415) $680 $850 3.5×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $224 $280 2.3×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $216 $270 2.2×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $320 $400 2.8×
X-ray nose-rectum child f.b. (76010) $224 $280 2.3×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $440 $550 3.8×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $408 $510 3.5×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $280 $350 2.9×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $288 $360 3.0×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $336 $420 2.9×
X-ray thoracic spine 4 vw (72074) $472 $590 4.1×
X-Ray Tmj Unilat (70328) $152 $190 1.6×
X-Ray Urinary Tract Exam With Contrast Material (74420) $808 $1,010 2.1×
X-Rays Bone Length Studies (77073) $392 $490 3.4×
X-Rays Bone Survey Complete (77075) $512 $640 4.4×
Xr c-spine 4 or 5 views (72050) $376 $470 3.2×
Xr facial bones less than 3 views (70140) $184 $230 1.9×
Xr myelogram posterior fossa (70010) $856 $1,070 2.2×
Xr orbits complete 4 views (70200) $304 $380 2.6×
Xr Tomogram Single Plane (76100) $488 $610 4.2×

A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.